This Blog is a Discussion of The Amazing Clinical Acumen and Clinical Skills of The Past Masters of The Human Arts
Beyond Mundane Modern Medical Science and Technology.
Their Feats of Diagnosis and Inspiration Needed to be Seen to be Believed. The Human Possibilities and Great Potential of The Clinician Are Being Forgotten. Let Us Remember Them Before They Are Forever Lost in The Mists of Time.

Pages

Friday, February 14, 2014

What is The Mind?

If there is one great mystery in healthcare and in everyday life, it is the human mind and its elements such as consciousness. The mind is our ever present experience. Its reality is beyond doubt as a result of that experience yet we cannot define or measure it directly.

The mind is proof of the existence and importance of the abstract in everyday life.

In healthcare, the question of mind and brain must be resolved to understand the relationship between medical psychiatry and clinical psychology. How do the use of drugs and 'talking therapies' interact and how can they be used most effectively and productively.

The mind also produces one of the most mysterious of all therapies, the placebo effect. Evidence is growing of just how important mental health and wellbeing are in preventing disease and the physical health consequences of stress, anxiety, depression and insomnia....

But what is the mind?

Here are some possible models.....

A Clinical Working Model
Clinical Psychologists generally use models of the mind rather than brain science and with therapies such as Cognitive Behavioural Therapy, they achieve clinically proven results under the strictest conditions of Evidence Based Medicine. They use these models to effectively deal with scientific mysteries such as the conscious and subconscious.

The scientific understanding of the brain's functioning in terms of chemicals, electricity and anatomy is of little practical help in Clinical Psychology. The patient cannot grasp it. The patient has no control over it. There is nothing that they can do directly about their neuronal interconnections or seretonin activity. They become dependent on the doctor and pharmaceuticals. They are disempowered by the language used.

It is like telling a Late Onset Diabetic that they have an autoimmune problem with their beta islet cells of the pancreas and peripheral insulin resistance. There is nothing that they can do about that science. The alternative is to tell them that they have eaten more sugars than their particular body can handle and that they have not burned those sugars up through exercise. That is something that they can relate to and that relates to their real, ordinary, everyday life. They can do something about it. They can participate in therapy by changing their diet and exercising more.

Clinical Psychology talks of thoughts, emotions, memories and beliefs that the patient can relate to and has direct power over. The educated and qualified therapist knows that these terms have some scientific backing. They are consistent with what is known of the brain but expressed in a more practical and accessible way.

Brain science will never be that accessible. It will never be that simple. The abstract concepts of the mind such as conscious, subconscious, thought, emotion, memories and belief are abstract concepts that encapsulate the science and make it much easier to deal with.

They are also capable of expressing and using what the science of the brain does not yet understand. That understanding is far from complete still. That does not stop Clinical Psychologists from using concepts such as the conscious and subconscious that science does not yet fully understand.

The Mind is The Bigger Picture
The abstract concept of the mind is larger than the brain. It is the whole of the nervous system at the very least. It incorporates the spinal cord, nerves of perception and the bodily organs that produce hormones, steriods and adrenaline. It can easily include the physiology of stress and relaxation as whole concepts.

The philosophical concept of the mind can include the fact that we can have silent, vocal discussions inside our heads with no physical explanation for this. It can include imagination and dreams when science can only talk of what happens in the body at these times.

Science can only talk of physical associations that can be measured, particularly with dreams but also with thought and consciousness. Reductionists will assume that what science can measure is causal based on their unproven axiom that science can explain everything, or nearly. Anybody without this faith can comprehend that this might be an interdependent relationship. Conscious, thought or dreams may just as well be causing these measureable changes in the body.

The Mind as A Reflection

One way to think of an interdependent relationship between the physical brain (and rest of the nervous system) and the abstract mind is to consider the mind as a reflection of the brain and body in a mirror. The reflection of the mind is not real. It is not physical but it does still exist. It can be perceived.

The mind can usefully be perceived just like our reflection in the mirror. We can use it to comb our hair into a particular style, apply war-paint or shave. We focus our attention on the reflection and use it to dictate our movements for real world, physical effects.

The object and the reflection are entirely interdependent on one another. When one moves, the other must move. When the reflection moves and changes, the body must have moved and changed.

Psychopharmaceuticals, street drugs, surgery and trauma change the reflection of the abstract mind. Clinical Psychology is like combing your hair in the mirror. Changes are made in the reflection of thought, consciousness and belief. They change the chemistry, even the micro-anatomy of the neural connections of the brain. They are used to change that chemistry and neuro-micro-anatomy that we cannot see directly.

With this model, both physical interventions and psychological interventions can be effective but combing the hair cannot change the gross nature of the brain or mind. They can only work with what they are given. Only major physical interventions can change the length or colour of the hair or the size of the nose.

Hardware and Software
This is simple metaphor. The brain is basically the hardware and the mind is a series of intangble software programs of learning, education, knowledge, logic, experience and memories. Of course, both are important. Both are interdependent on one another and work together to produce answers. Together, they produce thought.

In terms of major organic brain disease, obviously the usual software does not work. Trauma, brain diseases and congenital brain problems prevent the software from working. However, beyond that we all have the same brain anatomy and encoded genetic ability to produce the same neurotramsmitters. Only the more fluid epigenetic on/off switches dictate differences in levels. Beyond that, we all have the same hardware and the differences are in the programs.

We all have the same hardware throughout the ups and downs of life. A period of anxiety or depression does not change that. The hardware is essentially the same. These are differences in the software programs. They are learned differences. Clinical Psychology is based on the fact that anything that can be learned can also be unlearned.

Personally, I extend this metaphor or hypothesis to explain the conscious and unconscious mind. We have many different programs going on inside, each with its own logic and point of view. The conscious mind is like a screen that can only connect to one of these programs at a time. It knows what is going on with that program and follows its logic.

The conscious mind is only aware of one program and the other programs are subconscious. When anything in life, including a decision of the conscious mind upsets or unsettles them, they ring alarm bells felt as stress.

This ties in well with Freudian developmental psychology. As we age and mature, the conscious mind moves up a ladder of these software programs, each of which prodces its own specific mindset and worldview. Those worldviews that we have grown through and passed become the immature subconscious mind and they are in control of the physiology of stress/relaxation to express themselves.

This is also consistent with the laboratory psychology of learning, including reward and punishment, repetition and copying. It is consistent with Evidence Based Cognitive Behavioural Therapy models.

Those latent programs that we have not yet grown into, attuned to or learned to use are Freud's Super Ego. They are our conscience and the mysterious Higher Self that is talked of in spirituality. There is no mystery. They are just the programs that we have not gained the experience or knowledge to use yet.

The Brain as A Switchboard

A third metaphor or way to think of the mind and brain is that the mind is an invisible, intangible entity in its own right that is connected to the body, mainly via the brain. In this model, the brain can be thought of metaphorically as functioning rather like an old-fashioned, human-manned telephic switchboard with the operator directly plugging one call in to connect the call between the mind and body.

In this model, the mind is much larger with many different processes going on behind that scenes that are not plugged in. They are not conscious because they are not connected. They are unconscious but they are still happening somewhere behind the scenes. They may get connected to other organs such as the adrenal glands to produce adrenaline.

This model also gives primacy to the mind over the brain. Thought comes first. It is the caller. It is the thinker.

Perhaps that goes some way to describing the counter-intuitive fact that changing brain chemistry with anti-depressants does not have an immediate cause/effect relationship with the patient's mood or the hard symptoms of depression. It takes weeks to change. It is as if the anti-depressant blocks the switchboard and stops the depressed and depressing thoughts from coming through to consciousness. After a few weeks, the caller, the abstract mind gives up.

The same is true as brain injury or disease permanently damage an area of the switchboard. That area of the mind is permanently disconnected. That area of thought can never come through.

With this model, we are also moving towards an explanation of the placebo effect, the power of the mind over physical health. It is not conscious. This is an expression of the subconscious mind.

(I must find time to explain a theory that I have heard in the great oral tradition of medicine for the mind's map of cellular architecture that dictates cellular regeneration and differentiation....)

Is Higher Thought Beyond Present Science?
Could the mind really be an entity in its own right? Could it more than the brain and nervous system that current science comprehends?

I have never come across a serious attempt to explain rational thought or problem solving in science. In fact, everything I have heard conforms to the functioning of the subconscious mind as described in Cognitive Therapy. Memory as interrelated neuronal connects sounds just like a web of interconnected memories that create physiological knee-jerk reactions that typify the functioning of the subconscious mind rather than conscious thought processes.

It sounds to those that know the Cognitive Therapy model as if science is describing the subconscious mind rather than the conscious mind.

That would leave consciousness, thought and problem solving as scientific mysteries. My feeling is that there are parts of the mind that only a deeper understanding of these extra dimensions of SuperString Theory can hope to explain scientifically. Unfortunately, Super String Theory is not a science, at least not yet. It is a philosophy.....

My speculative hypothesis is that higher thought is in some way related to the Natural Laws of science. When science discovers where those laws come from, are recorded and how they are applied, they will have taken a massive step forwards in understanding the human mind in its totality.

Search This Blog

About Me

So Doctor Who was already taken for a doctor wishing to be anonymous and preserve their freedom of speech. It left which, what, where, why or when....
Doctor Which, pronounced 'witch', seemed most appropriate to a mystic journey into the archaic and arcane abilites of human clinicians that are beyond scientific explanation. The incredible feats that I have witnessed and even been taught to reproduce can only be explained by the high-end psychology of human potential in both perception and thought.
But sadly, the medical system prevents me from practicing the wonders I was taught. Teach perfection, practice compromise. I was not willing to compromise and practice substandard medicine. I was driven to early retirement.
Now I work as a general psychologist and am one of the few crossdisciplinary designers of the tools of cultural change in health, education and industry.
I am still a doctor at heart and soul and will do what I can to save my beloved vocation from what is being done to it at a cultural level...